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Canadian Journal of Gastroenterology
Volume 20, Issue 2, Pages 81-86
Original Article

Depression and Cigarette Smoking Independently Relate to Reduced Health-Related Quality of Life among Canadians Living with Hepatitis C

Louise Balfour,1,2,3 Curtis Cooper,1,2,3 John Kowal,1,2 Giorgio A Tasca,2,3,4 Amy Silverman,1 Marie Kane,1 and Gary Garber1,2,3

1The Ottawa Hospital Division of Infectious Diseases Viral Hepatitis Program, Ottawa, Ontario, Canada
2University of Ottawa, Ottawa, Ontario, Canada
3Ottawa Health Research Institute, Ottawa, Ontario, Canada
4Carleton University, Ottawa, Ontario, Canada

Received 18 May 2005; Accepted 20 July 2005

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Many people living with chronic viral hepatitis C (HCV) report reduced health-related quality of life. The relative contribution of behavioural, psychosocial and HCV disease factors to reduction in HCV health-related quality of life is not well understood. The objectives of the present study were to compare standardized health-related quality of life scores between Canadian HCV patients and age-matched Canadian and American norms, and to examine the relative contribution of biopsychosocial variables (ie, cigarette smoking, alcohol intake and depression) to health-related quality of life scores among Canadian HCV patients.

METHODS: HCV RNA-positive patients were recruited during their first visit to the Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Ontario). A questionnaire assessing health behaviours, health-related quality of life and depressed mood was completed. Data on liver studies, liver biopsy findings and HIV serostatus were also collected.

RESULTS: A total of 123 participants (71% men) ranging from 20 to 67 years of age were evaluated. All had compensated liver function. Patients reported significantly lower health-related quality of life compared with age-matched Canadian and American normative samples. In a series of hierarchical multiple regression models, depression and smoking were independently related to compromised health-related quality of life scores, even after controlling for sociodemographic variables and health behaviours.

DISCUSSION: These results highlight the value of adopting a biopsychosocial model of HCV care. Depressed mood and smoking behaviour should be evaluated in HCV patients. Empirically validated psychological and pharmacological treatments for depression and smoking cessation may improve health-related quality of life in HCV infected patients.